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VVM. EZ ProfileTm <br /> wwsrrr eawauuumwt <br /> Requested Facility: Midway Landfill O Unsure Profile Number: 125129CO <br /> ❑Multiple Generator Locations(Attach Locations) 10 Request Certificate of Disposal Cl Renewal?Original Profile Number: <br /> A.GENERATOR INFORMATION(MATERIAL ORIGIN) B.BILLING INFORMATION 2 SAME AS GENERATOR <br /> 1.Generator Name: Scott Contracting Inc. 1. Billing Name,Scott Contracljpg Inc. <br /> 2. Site Address:980 S.Yosemite Ct.Ste 150 2.Billing Address:FRBn S yosamitp Ct Stg 150 <br /> .(Qv.9tAll.ZIP)centennial CO 80112 (City,State,ZIP)Centennial CO 80112 <br /> :County: Arapahoe 3.Contact Name rndy r ntil <br /> 4.Contact Name:Cody Gentry 4.Email- rodyt pentrvr&s.ott.antra-inp cam <br /> 5-Email:sody.gent scoticontracing_com 5.Phone:�_Q).520.7341 6.Fax: <br /> 6- Phone: (Z n2)92&1341 7.Fax: 7.WM Hauled? O Yes 0 No <br /> 8:Generator EPA ID`-1R205207341 O N/A B.P.O.Number: <br /> 9.State ID. 27 N/A 9.Payment Method- ❑Credit Account O Cash 0 Credit Card <br /> C.MATERIAL INFORMATION D.REGULATORY INFORMATION <br /> 1.Common Name:Hydraut tc of I Impacted Sol I/Debris 1.EPA Hazardous Waste? O Yes' 0 No <br /> Describe Process Generating Material: O See Attached Code: <br /> Soil and/or Cleanup Debris( arps,Absorbents,Pads,PPE, 2.State Hazardous Waste? O Yes Q No <br /> Rags,Etc.)Contaminated with Hydraulic Oil due to a line Code: <br /> break,product spill or tank leak. 3.Is this material non-hazardous due to Treatment, O Yes* 0 No <br /> Delisting,or an Exclusion? <br /> 2.Material Composition and Contaminants: O See Attached 4.Contains Underlying Hazardous Constituents? ❑Yes' 0 No <br /> 1.soi 1 contaminated with hydraulic oil D_100% 5.From an industry regulated under Benzene NESHAP? O Yes' 0 No <br /> 2.Debris contaminated with hydraulic oil 0-100% 6.Facility remediation subject to 40 CFR 63 GGGGG? ❑Yes. ®No <br /> 7.CERCLA or State-mandated clean-up? ❑Yes 0 No <br /> 3. B.NRC or State-regulated radioactive or NORM waste? CI Yes* 0 No <br /> 4', <br /> Total comp.must be equal to or greater than 100% 2100% *If Yes,see Addendum(page 2)for additional questions and space. <br /> 3.State Waste Codes: 0 N/A 9.Contains PCBs? 4 If Yes,answer a,b and c. O Yes 0 No <br /> 4.Color.Various a Regulated by 40 CFR 7617 O Yes O No <br /> b. Remedaation under 40 CFR 761.61 (a)? O Yes O No <br /> 5.Physical State at 70'F: 0 Solid O liquid O Other: c. Were PCB imported into the US? O Yes ❑No <br /> 6.Free Liquid Range Percentage: to 0 N/A 10.Regulated and/or Untreated <br /> 7.pH: to L1 N/A Medical/Infectious Waste? O Yes No <br /> 8.Strong Odor: O Yes 0 No Describe: 11.Contains Asbestos? O Yes 0 No <br /> 9.Flash Point: ❑<1407 ❑140'-199'F O Z200' 0 N/A 4 If Yes: ❑Non-Friable O Non-Friable-Regulated O Friable <br /> E.ANALYTICAL AND OTHER REPRESENTATIVE INFORMATION F.SHIPPING AND DOT INFORMATION <br /> 1.Analytical attached O Yes 1.0 One-Time Event O Repeat Event/Ongoing Business <br /> Please identify applicable samples and/or lab reports: 2.Estimated Quantity/Unit of Measure:2 <br /> O Tons O Yards O Drums 0 Gallons O Other: <br /> 3.Container Type and Size:plastic bags from spill kit <br /> 4.USDOT Proper Shipping Name: 0 N/A <br /> 2,Other information attached(such as MSDS)? O Yes <br /> G.GENERATOR CERTIFICATION(PLEASE READ AND CERTIFY BY SIGNATURE) <br /> By signing this EZ Profile,form.I hereby certify that all information submitted in this and all attached documents contain true and accurate descriptions of this material,and that <br /> all relevant information necessary for proper material characterization and to identify known and suspected hazards has been provided. Any analytical data attached was derived <br /> from a sample that is representative as defined in 40 CFR 261-Appendix 1 or by us.nq an equivalent method. All changes occurring in the character of the material(i e,changes <br /> in the process or new analytical)will be identified by the Generator and be disclosed to Waste Management prior to providing the material to Waste Management. <br /> If I am an agent signing on behalf of the Generator.I have confirmed with the ------ <br /> --- <br /> --------- Certification Signature <br /> GeneratOr that Information contained in this Profile is accurate and complete. <br /> Name(Print): Cody Gentry Date: 04/26/2017 <br /> Title: Proiect Engineer <br /> Company: Scott Contracting Inc. <br /> Revised June 30.2015 <br /> THINK GREEN: QUESTIONS?CALL 800 963 4776 FOR ASSISTANCE 02015 Waste Management <br />